Does the Model for End-Stage Liver Disease Score Predict Transfusion Amount, Acid-Base Imbalance, Haemodynamic and Oxidative Abnormalities during Living Donor Liver Transplantation?

Abstract

The model for end-stage liver disease (MELD) score is associated with the severity of liver failure in transplant patients. This study examined whether life-threatening stress factors during liver transplantation differed according to the patients' preoperative MELD scores. Fortyfour patients who underwent living donor liver transplantation were divided into a high MELD group (MELD score ≥ 20) (n = 25) and a low MELD group (MELD score < 20) (n = 19). The volume of blood components transfused, acid-base homeostasis variables, and haemodynamic and oxidative variables were measured at each stage of the surgery. The systemic vascular resistance index was significantly lower in the high MELD group than in the low MELD group at all time points. The oxygen utility index and the oxygen extraction ratio were all significantly lower in the high MELD group than in the low MELD group only at the preanhepatic stage and not at later stages of surgery. Intraoperative transfusion volume and the severity of metabolic acidosis were not associated with the preoperative MELD score.

Anastomotic bilio-biliary stricture after adult liver transplantation: A retrospective study over 20 years in a single center

“…The impact of recipient's liver failure, estimated from bilirubin level, prothrombin time/INR or MELD score has been previously reported (10,11,13). We hypothesize that the most severely ill patients could have more intra-operative hemodynamic instability, leading to possible ischemic biliary damage (14). Finally, the risk of ABS was significantly increased by using steatotic liver graft, as reported previously (15 , 16).…”

Living Donor Liver Transplantation in South Asia: Single Center Experience on Intermediate‐Term Outcomes

“…It remains controversial whether high MELD scores are associated with worse short-and long-term post-LDLT outcomes [37][38][39][40]. It also remains unclear whether the frequency of blood transfusion and infection increases with high MELD scores [16,[41][42][43]. In the current study, MELD [30 was significantly associated with poor outcomes with a 4-year survival of only 57%.…”

Agreement between continuous cardiac output measured by the fourth-generation FloTrac/Vigileo system and a pulmonary artery catheter in adult liver transplantation

“…The MELD-Na score includes serum Na levels in the calculation and is a more accurate predictor of survival 15 . Cases with a high MELD score have a significantly lower SVR 16 and MELD-Na scores have a stronger negative correlation with SVR, compared to MELD scores 17 . In the current study, the MELD and MELD-Na scores were also negatively correlated with mean SVR, and MELD-Na scores showed a stronger negative correlation with PE and CR, compared to MELD scores.…”